0.05,respectively).The effect of test groups on the bacteria and fungi compared with that of control groups in dynamically monitoring showed significance(P

Objective To explore the cleaning effect of moisturizing through multiple enzymes cleaning fluid or alkaline cleaning fluid in the cleaning of medical equipment .Methods One thousand and two hundred surgical instruments used by cesarean delivery and recycled immediately from June 2013 to September 2013 were chosen and divided into the Ⅰ,Ⅱ,Ⅲ,Ⅳgroup according to the random number table , each with 300 .the ⅠandⅡgroup received the cleaning 2, 12 h after the moisturizing through the multiple enzymes cleaning fluid , respectively;and Ⅲ and Ⅳ group received the cleaning 2, 12 h after the moisturizing through the alkaline cleaning fluid , respectively .The qualification rates of cleaning were compared among the groups .Results No differences were found in the qualification rates of cleaning through the visual , microscopically and test paper detection between Ⅰ and Ⅲ groups ( P >0.05 ).The qualification rates of cleaning through the visual , microscopically and test paper detection were respectively 97.33% (292/300),96.33% (289/300) and 97.00%(291/300) in Ⅳ group, and were higher than 87.00% (261/300),86.33% (259/300) and 86.33%(259/300) in Ⅱ group, and the differences were statistically significant (χ2 =18.690,18.950, 14.592, respectively;P<0.01).The qualification rates of cleaning through the visual , microscopically and test paper detection were respectively 98.67% (296/300),98.00% (294/300) and 98.33% (295/300) in Ⅰgroup, and were higher than those of Ⅱgroup, and the differences were statistically significant (χ2 =30.688, 22.017,30.513, respectively;P <0.01).No differences were found in the qualification rates of cleaning betweenⅢandⅣgroups (P>0.05).Conclusions The surgical instruments after the normal use should be cleaned within 2 hours, and the moisturizing through multiple enzymes cleaning fluid or alkaline cleaning fluid can all ensure the cleaning quality .The surgical instruments after the use can not be cleaned within 2 hours, and should be firstly moisturized through the alkaline cleaning fluid and secondly cleaned through the machine so as to improve the cleaning quality of instruments .

BACKGROUNDE-cadherin is a subclass of the cadherin family that plays an important role in the maintenance of intercellular junctions in normal epithelium.Decreased expression of E-cadherin might be closely related to invasiveness and dedifferentiation in human cancers.There is increasing evidence that modulation of the E-cadherin-catenin cell-cell adhesion complex is an important step in the initiation and progression of human cancers.The aim of this study is to investigate the relationship between the level of E-cadherin mRNA expression and pathological grades and clinical stages of non-small cell lung cancer(NSCLC).

METHODSRT-PCR was used to measure the level of E-cadherin mRNA expression in 53 specimens of NSCLC,46 of para-cancer lung tissues,5 of benign nodal lung diseases,and the stages of disease was determined according to the results of surgery,pathology and imaging diagnoses.Then analyses were carried out between the level of E-cadherin mRNA expression and the clinical variables.

RESULTS45.3%(24/53) and 45.7%(21/46) specimens of NSCLC and para-cancer lung tissue were positive for E-cadherin mRNA expression respectively(P > 0.05);NSCLC with low differentiation,advanced stages and nodal metastases showed a magnificantly lower expression of E-cadherin mRNA(P < 0.05).The median survival time for E-cadherin mRNA positive and negative patients were 15.5 months and 46 months,respectively,but the expression of E-cadherin mRNA did not correlate with patient's survival(P > 0.05).

CONCLUSIONSE-cadherin expression is related to the differentiation,lymph node metastasis and pathological staging of NSCLC,but probably does not effectively affect its prognosis.

Objective: To analyze the characteristics of early gastric cancer (EGC) with submucosal infiltration under conventional white light endoscopy (C-WLE) and magnifying endoscopy with narrow band imaging (ME-NBI), and to improve the diagnostic accuracy of EGC infiltration by combining C-WLE and ME-NBI findings. Methods: Data of patients who received endoscopic submucosal dissection or surgical treatment for EGC at Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively analyzed. The basic information, lesion characteristics, and postoperative pathology of patients were collected. The characteristics of EGC with submucosal infiltration were analyzed, and a model for predicting the depth of EGC invasion was constructed by combining independent risk factors of submucosal infiltration. Results: A total of 207 lesions in 195 patients were included in the study, divided into the modeling group (138 lesions) and the testing group (69 lesions) in the ratio 2∶1. In the modeling group, the lesions located in the upper third of the stomach (OR=12.949, 95%CI: 2.148-78.070, P=0.005), middle third of the stomach (OR=7.534, 95%CI: 1.044-54.360, P=0.045), >2 cm in size (OR=6.828, 95%CI: 1.657-28.136, P=0.008) and presence of dilated blood vessel (OR=6.856, 95%CI: 1.577-29.805, P=0.010) were independent risk factors for submucosal infiltration. Based on the above independent risk factors, the infiltration depth predicting scoring system (DPSS) was constructed (5 points for the lesion located in upper third of the stomach, 4 points for the lesions located in the middle third of stomach, 4 points for lesions >2 cm in size, and 4 points for the presence of dilated vessels). The areas under the receiver operating characteristic curve for predicting the infiltration depth of DPSS were 0.884 (95%CI: 0.809-0.960) in the modeling group and 0.799 (95%CI: 0.684-0.914) in the testing group. The sensitivities of the modeling group and the testing group were 83.3% and 71.4% respectively; and the specificities were 76.2% and 74.5%, respectively in the two groups at 8 as the cut-off score. Conclusion The DPSS based on C-WLE and ME-NBI findings can predict the invasion depth of EGC.

Objective To analyze the possible influencing factors of postoperative bleeding after endoscopic submucosal dissection and endoscopic mucosal resection ( ESD/EMR) for early gastric cancer. Methods Clinical data of patients receiving ESD/EMR for the diagnosis of early gastric cancer at the Endoscopy Center of Beijing Friendship Hospital from January 2013 to May 2018, including demographic information ( age, gender and history ) , endoscopic lesion characteristics ( tumor size, location and morphology) and postoperative pathological features ( differentiated types and invasive depth) were collected to analyze the effects of these factors on bleeding after ESD/EMR. Results A total of 195 patients with early gastric cancer were included in the study and 9 cases ( 4. 6％) had postoperative bleeding. The medication history of clopidogrel and main lesion sizes were statistically different between postoperative bleeding group and non-bleeding group ( P=0. 018 and P=0. 034 ) . Multivariate analysis showed a history of clopidogrel ( OR=10. 223, 95％CI:1. 143-91. 468, P= 0. 038 ) , multiple lesions ( OR= 6. 412, 95％CI:1. 123-36. 616, P=0. 037) and lesions sizes of larger than 2 cm ( OR=6. 718, 95％CI:1. 130-39. 935, P=0. 036) were possible risk factors for postoperative bleeding. Survival analysis showed of higher postoperative bleeding risks in patients with the history of clopidogrel ( P<0. 001) and lesions sizes of more than 2 cm ( P=0. 022) . Conclusion More attention should be paid to the risk of ESD/EMR postoperative bleeding in early gastric cancer patients with medication history of clopidogrel and multiple large lesions.

Objective:To investigate the clinicopathological features of missed synchronous multiple early gastric cancer (SMEGC).Methods:Clinical and pathological data of 10 missed SMEGC patients in Beijing Friendship Hospital collected from January 2015 to December 2019 were reviewed for the clinicopathological and endoscopic features.Results:Ten missed SMEGC patients were all over 60 years old, and 6 of them were males. Six patients had family history of tumor and 6 had comorbidity (hypertension, diabetes, dyslipidemia, cardiovascular or cerebrovascular diseases). In terms of endoscopic and pathological manifestations, missed lesions of 6 cases were not smaller than the initial lesions, and more than half of the missed lesions had the same vertical location in the stomach (6/10), infiltration depth (8/10), histological classification (9/10), atrophic (8/10) and intestinal metaplasia (8/10) as the initial lesions.Conclusion:Physicians should be aware of the possibility of missed lesions during the first endoscopic treatment and the follow-up, especially at the same vertical location of the initial lesions in elderly males with family history of tumor and comorbidity.

Objective: To compare the efficacy and safety of endoscopic submucosal dissection(ESD) and surgery in the treatment of early gastric cancer. Methods: Clinical data of patients with early gastric cancer who received ESD or surgery in Beijing Friendship Hospital from June 2012 to May 2018 were collected. Complete resection rate, complication incidence, hospital stay and expenses between the two groups were compared. Results: There was no significant difference between two groups in complete resection rate[95.7%(245/256) VS 99.0%(97/98), P=0.191], or the complication incidence [5.9%(15/256) VS 8.2%(8/98), P=0.471]. Hospital stay was shorter in the ESD group than that in the surgery group(11.5±3.7 d VS 19.4±13.0 d, P=0.000). Expenses were less in the ESD group than those in the surgery group (27 383.1±10 143.0 yuan VS 78 004.3±79 027.8 yuan, P=0.000). Conclusion The efficacy and safety of ESD are comparable with surgery in the treatment of early gastric cancer, but ESD is superior to surgery in hospital stay and expenses.

Objective: To investigate the risk factors of operation time of endoscopic submucosal dissection (ESD) for superficial gastric lesions. Methods: Clinicopathologic data of 193 patients (195 lesions) diagnosed with early gastric cancer preoperatively who received ESD in Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively collected, including basic information (age, gender, body mass index, comorbidities), lesion characteristics (size, location, morphology), the operators′ experience of ESD, operation time, and postoperative pathology, etc. Univariate analysis was performed to find the risk factors of ESD operation time, and logistic regression analysis was performed on the factors with statistical differences in univariate analysis to find the independent risk factors of ESD operation time over 120 min. Results: The mean age of the patients was 63.34±9.11 years. The median time of ESD operation was 120.00 (95.00, 165.00) min and the median size of the lesions was 1.50 (1.00, 2.38) cm. Early gastric cancer was diagnosed by postoperative pathology in 164 lesions (84.10%), among which 162 lesions (98.78%) achieved en bloc resection, and 148 lesions (90.24%) achieved curative resection. The gender (P=0.018), location(P<0.001) and size (r=0.209, P=0.007) were risk factors of the operation time by univariate analysis, while age, body mass index, American Society of Anesthesiologists (ASA) grade, roughness of lesion surface, presence or absence of white moss and ulcer, depth of lesion invasion, operative period, gross shape of lesion, degree of differentiation, and experience of operator were not associated with operation time (all P>0.05). Multivariate analysis showed that the lesion located in cardia/fundus of stomach (OR=5.656, 95%CI: 2.291-13.964, P<0.001), body of stomach (OR=2.667, 95%CI: 1.048-6.785, P=0.040) and >2 cm in size (OR=2.761, 95%CI: 1.229-6.205, P=0.014) were independent risk factors for the operation time longer than 120 min. Conclusion Lesions located in the cardia/fundus, body of stomach and >2 cm in size are independent risk factors for long operation time of ESD.